title: Trauma and posttraumatic stress disorder in South Africa: analysis from the South African Stress and Health Study.
abstract: BACKGROUND
  South Africa's unique history, characterised by apartheid, a form of constitutional racial segregation and exploitation, and a long period of political violence and state-sponsored oppression ending only in 1994, suggests a high level of trauma exposure in the general population. The aim of this study was to document the epidemiology of trauma and posttraumatic stress disorder (PTSD) in the South African general population.
  
  
  METHODS
  The South African Stress and Health Study is a nationally representative survey of South African adults using the WHO's Composite International Diagnostic Interview (CIDI) to assess exposure to trauma and presence of DSM-IV mental disorders.
  
  
  RESULTS
  The most common traumatic events were the unexpected death of a loved one and witnessing trauma occurring to others. Lifetime and 12-month prevalence rates of PTSD were 2.3% and 0.7% respectively, while the conditional prevalence of PTSD after trauma exposure was 3.5%. PTSD conditional risk after trauma exposure and probability of chronicity after PTSD onset were both highest for witnessing trauma. Socio-demographic factors such as sex, age and education were largely unrelated to PTSD risk.
  
  
  CONCLUSIONS
  The occurrence of trauma and PTSD in South Africa is not distributed according to the socio-demographic factors or trauma types observed in other countries. The dominant role of witnessing in contributing to PTSD may reflect the public settings of trauma exposure in South Africa and highlight the importance of political and social context in shaping the epidemiology of PTSD.
authors.affiliation: Department of Mental Health, School of Medicine, Moi University College of Health Sciences, Eldoret, Kenya. lukoye.atwoli@uct.ac.za
authors.forename: Lukoye
authors.initials: L
authors.lastname: Atwoli
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.forename: David R
authors.initials: DR
authors.lastname: Williams
authors.forename: Katie A
authors.initials: KA
authors.lastname: Mclaughlin
authors.forename: Maria
authors.initials: M
authors.lastname: Petukhova
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Kessler
authors.forename: Karestan C
authors.initials: KC
authors.lastname: Koenen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D013019:South Africa / Q000453:epidemiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology*; D013315:Stress, Psychological / Q000453:epidemiology*; D014754:Violence / Q000706:statistics & numerical data; D014857:Warfare